How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $6.17 Typical High $6.31 | Professional | None | $2.63 | $6.17 | $6.31 |
BCBS Kansas Setting Facility Modifier None Typical Low $5.01 Median $5.37 Typical High $5.37 | Facility | None | $5.01 | $5.37 | $5.37 |
BCBS Kansas Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $3.02 | Facility | None | $2.82 | $2.82 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
Medica Setting Facility Modifier None Typical Low $2.51 Median $4.07 Typical High $79.43 | Facility | None | $2.51 | $4.07 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.58 Median $2.69 Typical High $23.44 | Professional | None | $1.58 | $2.69 | $23.44 |
United Setting Professional Modifier None Typical Low $1.38 Median $2.34 Typical High $3.02 | Professional | None | $1.38 | $2.34 | $3.02 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $3.09 Typical High $3.16 | Professional | 52 · Reduced service | $1.45 | $3.09 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $1.23 Typical High $1.26 | Professional | 53 · Discontinued | $0.58 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.91 Typical High $0.93 | Professional | 55 · Aftercare only | $0.43 | $0.91 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.62 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.28 | $0.62 | $0.63 |
Where Kansas sits
The same service costs 2.2 times more in Kansas than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kansas· 1st of 51
$5.25
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.